Project Summary/Abstract Independently, poor sleep and high levels of stress have been associated with cardiovascular, metabolic, and affective disorders. Emerging evidence suggests that poor sleep and stress are bi-directionally related, raising the possibility of a vicious feed-forward, self-sustaining cycle; i.e., stress promotes poor sleep which increases stress. More importantly, such a cycle could compound the independent disease risks of poor sleep and stress, hastening the development and progression of disease. Then again, since both sleep and stress represent modifiable targets for psychological and/or behavioral treatment, it might be possible to compound treatment effects through the same cycle. However, in order to appreciate the potential harm or potential treatment opportunity afforded by a bi-directional sleep-stress interaction its nature needs to be more clearly characterized. Long-term, the applicant aims to become an independent investigator of the mechanisms and health consequences of the bi-directional sleep-stress interaction. Consequently, the current proposal outlines a rigorous, assessment-based training plan specifically designed for the learning of sleep medicine theory and methodology and a complementary set of Specific Aims, generally aimed at systematically characterizing the bi-directional sleep-stress interaction using a range of research methods. First, meta-analysis will be used to quantitatively summarize the extant literature regarding the bi-directional sleep-stress interaction. Second, two waves of the Study of Women?s Health across the Nation (SWAN) Sleep Study will be analyzed using multilevel modeling with the intention of probing the sleep-stress interaction and determining its temporal stability. Third, a standardized psychological stress paradigm and polysomnography will be used to experimentally induce pre-sleep stress and probe the causal role of stress in disturbing sleep. This work fits into the mission of NHLBI to stimulate basic science into clinical practice by substantively contributing to the necessary understanding of how sleep and stress, ever-present aspects of modern daily life, interact, ultimately, to hasten the development and progression of disease, and/or provide a unique treatment target for the cardiovascular, metabolic, and affective disorders currently known to relate to poor sleep and high levels of stress.